Assessing Patient Experiences with Peripheral Intravenous Catheters: A Critical Evaluation of Quality of Life and Experience Measures

Introduction

Peripheral Intravenous Catheters (PIVCs) play a crucial role in healthcare, facilitating intravenous treatments for patients. However, common issues such as insertion failure and complications can adversely affect patient outcomes and experiences. This study aimed to evaluate the suitability of generic quality of life and experience measures in assessing the experiences of patients with PIVCs.

Background

PIVCs are widely used in healthcare, with two-thirds of patients in tertiary institutions requiring them for essential treatments. Complications, such as insertion failure and catheter-related problems, can lead to patient-reported pain, missed medication doses, and, in severe cases, morbidity and mortality. While clinicians often assess PIVC-related harm, it is crucial to consider patient-reported health outcomes and experiences. Health-Related Quality of Life (HRQoL) measures and Patient-Reported Experience Measures (PREMs) are essential tools in healthcare, but their use in the context of PIVCs has been limited.

Methods

This secondary analysis utilized data from a randomized controlled trial conducted in two tertiary hospitals in Queensland, Australia. Three instruments were employed: EuroQol Five Dimension - Five Level (EQ5D-5L), Functional Assessment of Chronic Illness Therapy – Treatment Satisfaction – General measure (FACIT-TS-G), and Australian Hospital Patient Experience Question Set (AHPEQS). The analysis aimed to assess discrimination, responsiveness, and potential ceiling/floor effects of these instruments in relation to PIVC outcomes.

Results

The study included 685 participants for EQ5D-5L, 264 for FACIT-TS-G, and 262 for AHPEQS. While individual items showed significance in relation to PIVC failure, the overall instruments demonstrated poor discrimination and responsiveness. Notably, all-cause PIVC failure was associated with specific items, such as increased mobility problems (EQ5D-5L), lower effectiveness and satisfaction (FACIT-TS-G), and unexpected physical and emotional harm (AHPEQS).

Conclusion

The analysis suggests that the investigated generic HRQoL and PREM instruments may be inadequate for assessing outcomes and experiences related to PIVCs. The study emphasizes the need for purpose-built measures, considering both quantitative and qualitative aspects, to comprehensively capture patient experiences with PIVCs. These findings contribute to the ongoing efforts to enhance the quality of care and safety in peripheral intravenous catheter use.

Read More: https://pubmed.ncbi.nlm.nih.gov/38167165/ 

Authors: Emily N Larsen, Nicole Marsh, Claire M Rickard, Gabor Mihala, Rachel M Walker, Joshua Byrnes